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Area of Science:

  • Ophthalmology
  • Regenerative Medicine
  • Infectious Diseases

Background:

  • Limbal stem cell deficiency (LSCD) impairs ocular surface integrity.
  • Ocular surface stem cell transplantation (OSST) aims to restore the ocular surface.
  • Infectious keratitis poses a significant risk following ocular surface reconstruction.

Purpose of the Study:

  • To determine the incidence of infectious keratitis after OSST.
  • To characterize the clinical and microbiological features of these infections.
  • To evaluate the outcomes of infectious keratitis in LSCD eyes post-OSST.

Main Methods:

  • Retrospective chart review of 278 eyes undergoing OSST (2006-2016).
  • Inclusion of eyes with prior infectious keratitis.
  • Assessment of demographics, risk factors, infection course, microbiology, and outcomes.

Main Results:

  • 18.7% of eyes developed infectious keratitis (75 episodes in 52 eyes).
  • Bacterial (58.7%) and fungal (32%) keratitis were most common; Gram-positive bacteria and Candida species predominated.
  • 25% required therapeutic keratoplasty, highlighting the severity of infections.

Conclusions:

  • Infectious keratitis is a frequent complication after OSST, necessitating vigilant management.
  • Aggressive medical and surgical interventions are essential for favorable outcomes.
  • Prophylactic measures and underlying conditions like cicatrizing conjunctivitis may influence infection patterns.